Laparoscopy-assisted resection for torsion of huge uterine subserosal leiomyoma : a case report

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  • TAMURA Yuko
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • KOSHIBA Akemi
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • KONDO Miho
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • YORIKI Kaori
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • ITO Fumitake
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • MORI Taisuke
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • KUSUKI Izumi
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • KITAWAKI Jo
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine

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Other Title
  • 腹腔鏡補助下に治療した巨大漿膜下子宮筋腫茎捻転の1例
  • 症例報告 腹腔鏡補助下に治療した巨大漿膜下子宮筋腫茎捻転の1例
  • ショウレイ ホウコク フククウキョウ ホジョ カ ニ チリョウ シタ キョダイショウマク カ シキュウ キンシュ ケイ ネンテン ノ 1レイ

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<p>Uterine leiomyoma torsion, a rare disease found in 0.1-0.3% cases of uterine leiomyoma surgery, presents with acute abdominal pain and requires urgent treatment. We report a case of laparoscopically assisted myomectomy (LAM) for uterine fibroid torsion. A 28-year-old nulligravid woman visited a local clinic because of sudden lower abdominal pain. An abdominal mass the size of a child’s head was identified by transabdominal sonography, and she was referred to our hospital. During physical examination, a mass in the midline of the lower abdomen was palpated and tenderness and rebound pain was observed. Blood tests indicated inflammation. Magnetic resonance images showed a 12-cm subserosal uterine leiomyoma and a myoma pedicle spanning the uterus to myoma. No contrast effect was observed inside the tumor. Our diagnosis was uterine leiomyoma torsion, and we performed LAM with a 3-cm transverse skin incision in the lower abdomen. The uterine leiomyoma developed from the uterine anterior wall, and the pedicle was twisted 360° counterclockwise. The resected leiomyoma was removed through a small abdominal incision. The pathological diagnosis was degenerative leiomyoma. We conclude that laparoscopic surgery with small incisions is particularly useful for pedunculated subserosal leiomyoma, even large ones. [Adv Obstet Gynecol, 71(2) : 128-134, 2019 (R1.5)]</p>

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